[{"data":1,"prerenderedAt":315},["ShallowReactive",2],{"article-/articles/the-mothers-of-gynecology":3,"article-women-/articles/the-mothers-of-gynecology":288,"article-linked-/articles/the-mothers-of-gynecology":284,"related-/articles/the-mothers-of-gynecology":293},{"id":4,"title":5,"body":6,"category":267,"date":268,"description":269,"extension":270,"featured":271,"image":272,"imageCredit":273,"meta":274,"navigation":271,"ogFocal":275,"path":276,"readingTime":277,"reflectionPrompt":278,"seo":279,"seoDescription":280,"seoTitle":281,"slug":282,"stem":283,"updated":284,"women":285,"__hash__":287},"articles/articles/the-mothers-of-gynecology.md","They Operated On Her Thirty Times: The Women Who Built Modern Gynaecology",{"type":7,"value":8,"toc":252},"minimark",[9,13,16,19,22,25,30,33,36,39,43,46,49,52,55,58,62,65,68,71,77,80,84,87,90,93,96,99,103,106,109,112,115,118,122,125,128,131,134,138,141,144,147,150,153,156,159,162,165,169,172,175,178,181,184,188,191,194,197,200,204,207,210,213,222,226,229,232,235,238,241,244,247],[10,11,12],"p",{},"Somewhere near you, in a drawer in a clinic, there is a metal instrument shaped like a duck's bill.",[10,14,15],{},"If you have ever had a pelvic examination, you have met it. It carries the surname of the man who invented it, and every medical student on earth learns that surname.",[10,17,18],{},"He made the first one in 1845, in a backyard in Montgomery, Alabama, by bending the handle of a pewter spoon. He was looking inside the body of a young woman who could not tell him to stop, because he had not asked her. He had asked the man who owned her, and they had come to an arrangement.",[10,20,21],{},"Her name was Betsey. That is very close to the whole of what anybody knows about her. No surname. No birth year. No face.",[10,23,24],{},"This is what happened to her, and to Lucy, and to Anarcha, and to the others, perhaps nine more, whose names nobody thought to write down.",[26,27,29],"h2",{"id":28},"she-laboured-for-three-days","She laboured for three days",[10,31,32],{},"Anarcha was about seventeen. The baby would not come. For three days the child's head pressed the soft tissue of the birth canal against the bone of the pelvis until that tissue died. A hole opened between her bladder and her vagina. A second one opened into the bowel. The baby was dead. Urine left her body constantly, and there was nothing at all she could do about it. Not at night. Not at a funeral. Not when someone came close enough to smell her.",[10,34,35],{},"The injury is called an obstetric fistula. In 1845 it was considered incurable. Nobody anywhere in the world could reliably close it. Women who developed one were put in outbuildings and left there.",[10,37,38],{},"So if you later hear that these women wanted the surgery, they had every reason to. That is not the difficult question. The difficult question is what wanting something means when refusing is not available to you.",[26,40,42],{"id":41},"the-arrangement","The arrangement",[10,44,45],{},"James Marion Sims was a young doctor in Montgomery who had built a small hospital in his backyard specifically to hold enslaved patients. He wrote later, without embarrassment, that he built it \"as a special field of experiment\".",[10,47,48],{},"He went looking for subjects and found them. In his own account he \"ransacked the county\" and turned up six or seven women with fistulas who had been hidden away for years.",[10,50,51],{},"Then he made his offer to the men who owned them. He would keep the women and charge nothing for their board. In exchange he wanted them for experiment, and the owners had to pay their taxes and their clothes.",[10,53,54],{},"A negotiation took place about these women's bodies. The women were in the room for none of it.",[10,56,57],{},"There was also a reason the owners said yes that has nothing to do with mercy. A woman leaking urine could not do the work they wanted from her, and could not bear more children for them to own. Repairing her restored her price.",[26,59,61],{"id":60},"lucy-went-first","Lucy went first",[10,63,64],{},"She was eighteen and had given birth about two months earlier. It was December 1845.",[10,66,67],{},"They put her on her knees. The operation took roughly an hour. To drain the bladder afterwards Sims improvised with a sponge and a catheter, and the sponge hardened inside her and had to be pulled out. She went septic. She was ill for months.",[10,69,70],{},"Here is how he described it, nearly forty years later, in his autobiography:",[10,72,73],{},[74,75,76],"em",{},"Lucy's agony was extreme. She was much prostrated, and I thought that she was going to die.",[10,78,79],{},"She did not die. When she had recovered enough, he put her on a table and examined her again.",[26,81,83],{"id":82},"twenty-nine-failures","Twenty-nine failures",[10,85,86],{},"Anarcha was next, and Anarcha is the one the arithmetic sticks to.",[10,88,89],{},"Sims operated on her, failed, and operated again. He recorded twenty-nine failures. The thirtieth, in June 1849, worked. He had switched from silk thread to silver wire, and the wound finally closed without infection.",[10,91,92],{},"Four years. Thirty times on the same table.",[10,94,95],{},"When it succeeded he wrote that he had made \"one of the most important discoveries of the age for the relief of suffering humanity\". He was not wrong about the discovery. Fistula repair is still built on what he found, and it has given millions of women their lives back.",[10,97,98],{},"He was wrong about whose discovery it was.",[26,100,102],{"id":101},"the-thing-about-the-anaesthetic","The thing about the anaesthetic",[10,104,105],{},"Ether was demonstrated publicly at Massachusetts General Hospital in October 1846, which is to say halfway through the four years he spent operating on Anarcha.",[10,107,108],{},"He did not use it on her. Nobody disputes this, including the historians who defend him.",[10,110,111],{},"You will often see this written up as a simple racial split, that he used anaesthetic on white women and withheld it from Black women. The truth is narrower and worse. Deirdre Cooper Owens, the historian who has done the most careful work on this period, points out that when Sims moved to New York he operated on a poor Irish immigrant named Mary Smith about thirty times as well, also without anaesthetic, also in front of an audience. The women he did anaesthetise were the rich ones. In 1861 he gave chloroform to a French patient he described as young, beautiful, rich and accomplished.",[10,113,114],{},"And here is his own explanation, published in 1858, for why he did not bother with the others. The operations, he wrote, are \"not painful enough to justify the trouble\".",[10,116,117],{},"Set that sentence beside the one he wrote about Lucy. Her agony was extreme. He knew. He wrote it down himself.",[26,119,121],{"id":120},"they-held-each-other","They held each other",[10,123,124],{},"The white doctors who had been assisting Sims got bored and disgusted and walked away. The work was unpleasant and it kept failing. So he replaced them with the only people left in the building.",[10,126,127],{},"The women assisted at each other's surgeries. They held the speculum. They held each other down. They cleaned the instruments and passed them back. Then they healed, went back to work in the house and the fields, and waited for their own turn on the table again.",[10,129,130],{},"Cooper Owens makes the point that has to be made about this: by the end, these women knew more about repairing a vesicovaginal fistula than almost any physician in the United States. They were skilled surgical workers. They were also still property, and they could not stop.",[10,132,133],{},"Anarcha assisted at operations. Anarcha was operated on thirty times. Both of those are true about the same person.",[26,135,137],{"id":136},"what-happened-to-him","What happened to him",[10,139,140],{},"He moved to New York in 1853. He founded the Woman's Hospital, the first hospital for women in the United States, in 1855. He became president of the American Medical Association in 1876 and the founding president of the American Gynecological Society.",[10,142,143],{},"In 1894 they put up a bronze statue of him in Bryant Park, the first statue of a doctor ever erected in America. It was later moved to Fifth Avenue at 103rd Street, on the edge of Central Park, facing the New York Academy of Medicine, where it stood for eighty-four years.",[10,145,146],{},"In August 2017 somebody painted the word RACIST across it. On the morning of 17 April 2018 the city took it down and sent it to the cemetery in Brooklyn where he is buried, and there it sits in storage.",[10,148,149],{},"The empty pedestal is still in Central Park.",[10,151,152],{},"People still argue about him, and not only the people you would expect. In 2006 the physician L. L. Wall published a paper in the Journal of Medical Ethics arguing that the case against Sims has been overstated. His points are not stupid. Fistula was a catastrophe with no cure, so the surgery was therapeutic rather than idle experiment. Early anaesthesia was contested and dangerous, and short perineal procedures were routinely done without it on everyone. And, he argues, the women cooperated.",[10,154,155],{},"The rebuttal is not that Wall invented his facts. It is that cooperation and consent are different things, and slavery is precisely the machine that separates them.",[10,157,158],{},"Durrenda Ojanuga put it plainly: these women had no claim to decisions about their own bodies or any other part of their lives. The scholar Bettina Judd sharpens it further. Consent is not measured by whether you said yes. It is measured by whether you could have said no.",[10,160,161],{},"Every word we have about what those women wanted comes from Sims, written down thirty-five years afterwards, by the person with the most to gain from a particular answer. Not one sentence from Anarcha, Lucy or Betsey survives. They were forbidden by law from learning to write.",[10,163,164],{},"The historian Vanessa Northington Gamble offers the honest position: they may well have wanted the surgery, and they could not have refused it, and both of those things sit in the record at once, and nobody gets to resolve it on their behalf.",[26,166,168],{"id":167},"a-stone-against-a-tree","A stone against a tree",[10,170,171],{},"For a hundred and seventy years the story stopped at the thirtieth operation, because that is where Sims stopped writing.",[10,173,174],{},"In 2023 the writer J. C. Hallman published a book that tried to follow her past it. He traced a woman through property listings and household registers under the spellings Anaka and Ankey. She turns up in New York in 1856, admitted to Sims's Woman's Hospital at thirty-two and discharged the following January. How she got there, nobody knows. Later she was enslaved in Caroline County, Virginia. From 1864 she considered herself married to a formerly enslaved man named Lorenzo Jackson. After the war she had a husband, children and land of her own.",[10,176,177],{},"In woods on private property in King George County, Virginia, there is a fallen headstone leaning against a tree. The name cut into it is Annacay Jackson. Lorenzo is buried beside her, and two infants beside him. She was about forty-eight. The stone says 1869 and the county record says 1870, and the two have never been reconciled.",[10,179,180],{},"Hallman is careful, and you should be too. He calls his own book a book about a ghost, and says openly that it mixes evidence with inference and guesswork. Reviewers have pushed back hard on some of his choices. He also points out something that ought to be uncomfortable for all of us: she never called herself Anarcha Westcott. That is the name we gave her, afterwards, once we decided to remember.",[10,182,183],{},"Still. Somebody spent a hundred and seventy years being a footnote in a surgeon's memoir, and now there is a grave with a name on it.",[26,185,187],{"id":186},"fifteen-feet-of-scrap-metal","Fifteen feet of scrap metal",[10,189,190],{},"In Montgomery, about a mile from a second statue of Sims that still stands on the Alabama State Capitol grounds, there are three figures on Mildred Street.",[10,192,193],{},"The artist Michelle Browder built them out of scrap metal that people donated, because, as she has said, these women were discarded. Anarcha stands fifteen feet tall. The other two are twelve feet and nine feet. Anarcha's womb is packed with sharp objects. Betsey wears a crown made of speculums, engraved with the names of other women. Lucy's hair is made of bicycle chain.",[10,195,196],{},"They were unveiled in September 2021. Browder has since bought the building at 33 South Perry Street, the address where the backyard hospital stood, and is raising money to turn it into a clinic for women who cannot afford one.",[10,198,199],{},"She calls the three of them the Mothers of Gynaecology. That was the point of the name. He has been called the father of it for a hundred and fifty years, and somebody was always missing from the sentence.",[26,201,203],{"id":202},"a-tuesday-in-northern-nigeria","A Tuesday in northern Nigeria",[10,205,206],{},"Anarcha's injury is not a nineteenth-century problem.",[10,208,209],{},"UNFPA estimates that more than four hundred thousand Nigerian women are living with an untreated obstetric fistula right now, and that Nigeria carries something in the region of forty per cent of the world's cases. UNFPA's own repair programmes manage about three thousand operations a year.",[10,211,212],{},"A fistula happens when a woman labours too long without a surgeon, which happens when she is too young, too far from a hospital, too poor, or nobody thought it was urgent. Every one of those is a decision somebody made. The repair Sims found on Anarcha's body works. It has worked for a hundred and seventy-five years. The women it was taken from are still the women least likely to receive it.",[10,214,215,216,221],{},"Which is why the work of people like ",[217,218,220],"a",{"href":219},"/women/edna-adan-ismail","Edna Adan Ismail",", who built a maternity hospital in Hargeisa and has spent her life training midwives for the places that have none, is not charity. It is repayment on a debt that was opened in a backyard in Alabama in 1845 and has never once been settled.",[26,223,225],{"id":224},"the-instrument","The instrument",[10,227,228],{},"Go back to the drawer.",[10,230,231],{},"There is a movement among doctors now to stop calling it by his name. Some journals and hospitals have started writing \"vaginal speculum\" instead, and a few have proposed calling it Lucy's speculum, after the girl who went first and nearly died for it.",[10,233,234],{},"It is a small thing. Renaming an object does not give anyone back four years of their life.",[10,236,237],{},"But he named it after himself, and he named the position after himself, and for a century and a half the only person in that backyard anyone could name was the one holding the spoon.",[10,239,240],{},"Betsey. Lucy. Anarcha.",[10,242,243],{},"That is not much to ask.",[245,246],"hr",{},[10,248,249],{},[74,250,251],{},"Sources: Deirdre Cooper Owens, \"Medical Bondage: Race, Gender, and the Origins of American Gynecology\" (University of Georgia Press, 2017); J. Marion Sims, \"The Story of My Life\" (1884) and \"Silver Sutures in Surgery\" (1858); Harriet Washington, \"Medical Apartheid\" (2007); J. C. Hallman, \"Say Anarcha\" (Henry Holt, 2023); Monica Cronin, \"Anaesthesia and Intensive Care\" (2020); L. L. Wall, \"The medical ethics of Dr J Marion Sims: a fresh look at the historical record\", Journal of Medical Ethics 32:6 (2006); Durrenda Ojanuga, Journal of Medical Ethics (1993); Spettel and White, Journal of Urology (2011); Capital News Service, Maryland (2024); Smithsonian Magazine; UNFPA Nigeria.",{"title":253,"searchDepth":254,"depth":254,"links":255},"",2,[256,257,258,259,260,261,262,263,264,265,266],{"id":28,"depth":254,"text":29},{"id":41,"depth":254,"text":42},{"id":60,"depth":254,"text":61},{"id":82,"depth":254,"text":83},{"id":101,"depth":254,"text":102},{"id":120,"depth":254,"text":121},{"id":136,"depth":254,"text":137},{"id":167,"depth":254,"text":168},{"id":186,"depth":254,"text":187},{"id":202,"depth":254,"text":203},{"id":224,"depth":254,"text":225},"History","2026-09-11","There is an instrument in every gynaecologist's room in the world. It was designed in 1845 on the body of an enslaved woman who was not allowed to say no. Her name was Betsey, and that is nearly all of her name there is.","md",true,"/articles/the-mothers-of-gynecology.jpg","Original illustration in honour of Anarcha, Lucy and Betsey. No verified photograph of them survives.",{},"50% 20%","/articles/the-mothers-of-gynecology",12,"Anarcha, Lucy and Betsey assisted at each other's surgeries and became more skilled at the operation than most doctors in America. Whose expertise around you goes unnamed?",{"title":5,"description":269},"Modern gynecology was built on surgery performed on enslaved women without anaesthetic. Anarcha endured about thirty operations. This is their story.","Anarcha, Lucy and Betsey: The Mothers of Gynecology","the-mothers-of-gynecology","articles/the-mothers-of-gynecology",null,[286],"edna-adan-ismail","gek2hun-NKCMxWAVr4qzpbbDQzeMB4qshUzy8QHH4Ro",[289],{"name":220,"slug":286,"image":290,"country":291,"born":292,"died":284,"ogFocal":284},"/women/edna-adan-ismail.jpg","Somaliland",1937,[294,301,308],{"title":295,"slug":296,"category":267,"image":297,"description":298,"readingTime":299,"date":300},"When Men Go to War, Women Suffer: The Rwanda Genocide and What Was Done to Women","when-men-go-to-war-women-suffer","/articles/when-men-go-to-war-women-suffer.jpg","In 100 days in 1994, between 250,000 and 500,000 women were raped in Rwanda. This is the story of why it happened, what the world did about it, and how Rwandan women rebuilt an entire country from the ruins.",10,"2026-06-08",{"title":302,"slug":303,"category":267,"image":304,"description":305,"readingTime":306,"date":307},"What Her Cloth Said When She Could Not Speak","what-her-cloth-said-when-she-could-not-speak","/articles/what-her-cloth-said-when-she-could-not-speak.jpg","Across East Africa, women have been buying, wearing, and gifting printed cloths that carry messages most people cannot read. A kanga is never just a kanga. It is a letter you wear on your body.",5,"2026-04-09",{"title":309,"slug":310,"category":267,"image":311,"description":312,"readingTime":313,"date":314},"The Voice That Crossed the Sea: Charlotte Maxeke and the Long Road Home","charlotte-maxeke-voice-across-the-sea","/women/charlotte-maxeke.jpg","Before she was the Mother of Black Freedom in South Africa, she was a girl with a voice that filled concert halls in London. This is how a singer became a scholar, then a force the colonial state could not ignore.",4,"2026-03-26",1789137112906]